The Effect of Prematüre İnfant Oral Motor İntervention (PIOMI) and Chronobiological Approach to Feeding on Readiness to Feed, Transition to Total Oral Feeding, and Body Weight in Preterms

NCT ID: NCT07306793

Last Updated: 2025-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

54 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-01

Study Completion Date

2026-09-30

Brief Summary

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This is a randomized controlled experimental study evaluating the effects of oral motor intervention and chronobiological approach to feeding model applied to preterm infants on feeding readiness, transition to total oral feeding and body weight.

Detailed Description

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Premature birth is defined as birth occurring before the 37th week of gestation, and approximately 15 million babies are born this way worldwide each year. Premature babies experience feeding difficulties because their oral feeding skills, sucking-swallowing-breathing coordination, and oral structures are not fully developed. Their oral motor systems typically mature between 32-34 weeks of gestation. The development of the oral motor system is crucial for adequate nutrition, growth, and weight gain. Several methods are used to improve the oral motor development of premature babies. Oral motor interventions involve physical stimuli applied to intraoral structures such as the lips, tongue, cheeks, gums, and palate. These methods aim to increase the functional strength of oral muscles and target neuro-behavioral synergy.

Oral motor interventions applied in NICUs have been shown to accelerate the transition to oral feeding, increase weight gain, and shorten hospital stays in premature infants. Premature Infant Oral Motor Intervention (PIOMI) is one of the interventions applied in NICUs. Studies have shown that PIOMI is more effective than other interventions in this field. Furthermore, no negative side effects of PIOMI have been reported.

Breast milk is an ideal source of nutrition for the growth and development of preterm infants. It provides essential nutrients for the baby's growth and development, as well as containing biological cues that help regulate circadian rhythms. For the fetus, which has become accustomed to the mother's circadian rhythms during intrauterine life, it supports this transition process by providing similar cues after birth. The composition of breast milk can vary depending on gestational age, lactation stage, and pumping time. Differences are particularly observed between day and night breast milk in terms of circadian rhythms. Daytime milk contains higher levels of substances such as immune system-related nucleotides, interleukins, and antioxidants, while nighttime milk is rich in sleep-regulating components such as melatonin and tryptophan. This difference is important for the transmission of the mother's biological rhythms to the baby, contributing to the regulation of the baby's sleep-wake cycle and improving its environmental adaptation.

The chronobiological feeding model suggests that expressed breast milk be given in periods of day and night, or more specifically, in six-hour cycles, in accordance with the daily cycle. This approach aims to support the development of the infant's circadian rhythm through expressed breast milk in situations where breastfeeding is not possible. A review of the literature revealed no studies that combined PIOMI with chronobiological feeding. Therefore, this research was planned to determine the effects of oral motor intervention (PIOMI) and chronobiological feeding on feeding readiness, transition to total oral feeding and body weight in preterm infants hospitalized in the NICU.

Conditions

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Neonatal İntensive Care Nutrition With A Chronobiological Approach Readiness For Feding Body Weight Breast Milk Nutrition Premature - Weight 1000g-2499g or Gestation of 28-37weeks

Keywords

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Neonatal İntensive Care Nutrition With A Chronobiological Approach Readiness For Feding Body Weight Transitioning To Total Oral Feeding Premature Infant Oral Motor Intervention (PIOMI) Prematüre

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a randomized controlled experimental study. There are three groups: the PIOMI study group, the chronobiological feeding model study group, and a control group.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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PIOMI study group

Premature infant group undergoing Oral Motor Intervention.

Group Type EXPERIMENTAL

PIOMI study group

Intervention Type OTHER

Infants will be weighed at 8:30 AM wearing only a clean diaper, and the scale will be disinfected before and after each use. Preterm infants in this group will receive PIOMI treatment at their bedside for 5 minutes, once a day, 15 minutes before feeding times at 9:00 AM or 12:00 PM, for 14 days. Before starting the PIOMI treatment, the researcher will remove any jewelry and wash their hands hygienically. Following the PIOMI treatments, infants will be fed using the feeding method applied in the clinic, and this will be recorded. Infants will be monitored throughout their stay in the NICU.

Nutrition Study Group with a Chronobiological Approach

Group of infants fed using chronobiological approaches

Group Type EXPERIMENTAL

Nutrition Study Group with a Chronobiological Approach

Intervention Type OTHER

Newborns will be weighed at 8:30 a.m. wearing only a clean diaper, and the scale will be disinfected before and after each use. The researcher will provide training to the baby's mother on breast milk expression and storage. Breast milk storage bags and adhesive labels labeled "NIGHT MILK" and "DAY MILK" will be provided by the researcher. Mothers will be asked to express milk between 06:00 and 17:59, place it in a breast milk storage bag, attach the "DAY MILK" label, and write their name, surname, date, and time on it. For milk expressed between 18:00 and 05:59, they will place it in a breast milk storage bag, attach the "NIGHT MILK" label, and write their name, surname, date, and time on it, and bring their milk to the unit in this manner. Newborns in this group will be fed using breast milk that is chronobiologically matched.

No Intervention

Control group.

Group Type OTHER

Control group

Intervention Type OTHER

Newborns will be weighed at 8:30 AM wearing only a clean diaper, and the scale will be disinfected before and after each use. No procedures will be performed on these infants outside of the clinical routine. Infants will be fed using the same feeding method as in the clinic. Infants will be monitored throughout their stay in the NICU.

Interventions

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PIOMI study group

Infants will be weighed at 8:30 AM wearing only a clean diaper, and the scale will be disinfected before and after each use. Preterm infants in this group will receive PIOMI treatment at their bedside for 5 minutes, once a day, 15 minutes before feeding times at 9:00 AM or 12:00 PM, for 14 days. Before starting the PIOMI treatment, the researcher will remove any jewelry and wash their hands hygienically. Following the PIOMI treatments, infants will be fed using the feeding method applied in the clinic, and this will be recorded. Infants will be monitored throughout their stay in the NICU.

Intervention Type OTHER

Nutrition Study Group with a Chronobiological Approach

Newborns will be weighed at 8:30 a.m. wearing only a clean diaper, and the scale will be disinfected before and after each use. The researcher will provide training to the baby's mother on breast milk expression and storage. Breast milk storage bags and adhesive labels labeled "NIGHT MILK" and "DAY MILK" will be provided by the researcher. Mothers will be asked to express milk between 06:00 and 17:59, place it in a breast milk storage bag, attach the "DAY MILK" label, and write their name, surname, date, and time on it. For milk expressed between 18:00 and 05:59, they will place it in a breast milk storage bag, attach the "NIGHT MILK" label, and write their name, surname, date, and time on it, and bring their milk to the unit in this manner. Newborns in this group will be fed using breast milk that is chronobiologically matched.

Intervention Type OTHER

Control group

Newborns will be weighed at 8:30 AM wearing only a clean diaper, and the scale will be disinfected before and after each use. No procedures will be performed on these infants outside of the clinical routine. Infants will be fed using the same feeding method as in the clinic. Infants will be monitored throughout their stay in the NICU.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Preterm infants with a postnatal age of 29-33 weeks,
* Whose vital signs and clinical condition have been stable for at least 24 hours,
* Whose APGAR score at 1 and 5 minutes (Activity-Pulse-Grimace-Appearance-Respiration) is 4 or higher.

Exclusion Criteria

* Infants with major congenital anomalies (such as congenital heart disease, cleft palate, cleft lip) or birth trauma,
* Infants with RDS,
* Infants diagnosed with asphyxia,
* Infants with intraventricular hemorrhage,
* Infants with Neonatal Withdrawal Syndrome,
* Infants with Fetal Alcohol Syndrome,
* Infants included in the study group who develop any complications or whose stable condition deteriorates during the follow-up period,
* Infants with feeding intolerance or who are interrupted from feeding for more than 48 hours,
* Infants who develop sepsis,
* Infants who develop necrotizing enterocolitis,
* Infants receiving mechanical ventilation support,
* Infants who receive narcotic analgesia or sedation,
Minimum Eligible Age

29 Weeks

Maximum Eligible Age

33 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Aydin Adnan Menderes University

OTHER

Sponsor Role lead

Responsible Party

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Esra Bozkurt

PhD student

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Aydın Adnan Menderes University, Faculty of Nursing, Department of Child Health and Disease Nursing

Aydin, Aydın, Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Esra Bozkurt, PhD student

Role: CONTACT

Phone: +905468213722

Email: [email protected]

Seher Sarıkaya Karabudak, Associate Professor

Role: CONTACT

Phone: +905054483703

Email: [email protected]

Facility Contacts

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Esra Bozkurt, PhD student

Role: primary

Other Identifiers

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Interventional trial

Identifier Type: -

Identifier Source: org_study_id